| Date of birth: | Oct 5, 1942 |
| Hold: | no |
| Arresting agency: | POLK COUNTY SHERIFF |
| Booking number: | 2010-018147 |
| Booking date: | Aug 3, 2010 |
| Release date: | Aug 4, 2010 |
| Booking location: | Polk County, FL |
| Statute: | 784.03(1A1) BATTERY-TOUCH OR STRIKE |
| Charge on arrest docket: | BATTERY TOUCH OR STRIKE DOMESTIC VIOLENC |
| Charge number: | 1 |